Hand Position, CPR Quality and Rescuer Comfort

High-quality chest compressions are a key component of cardiopulmonary resuscitation (CPR). Current international resuscitation guidelines recommend placing one hand on top of the other during chest compressions, but recommendations regarding whether the fingers should be interlocked or simply placed on top of each other are based on limited scientific evidence.

This prospective, randomized, controlled crossover simulation study will compare two hand positions during continuous chest compressions on an adult CPR manikin. Each participant will perform two 2-minute chest compression periods, using both techniques in a computer-randomized order: (1) interlocked fingers, representing the commonly taught technique, and (2) non-interlocked hands placed one on top of the other. A 10-minute seated rest period will separate the two measurement periods.

The primary outcome will be mean chest compression depth. Secondary outcomes will include compression rate, proportion of compressions with adequate depth and full chest recoil, temporal changes in compression depth, and subjective assessments of pain, discomfort, physical fatigue, hand-position stability, and confidence in performing chest compressions. Participants will also indicate which technique they would prefer in a real resuscitation situation.

The study will be conducted in a simulation environment at the Human Patient Simulation Center of the University of Pécs Faculty of Health Sciences. Participants will not receive real-time feedback from the manikin during the measurements.